A call to alarms: Current state and future directions in the battle against alarm fatigue

被引:61
作者
Hravnak, Marilyn [1 ]
Pellathy, Tiffany [1 ]
Chen, Lujie [2 ]
Dubrawski, Artur [2 ]
Wertz, Anthony [2 ]
Clermont, Gilles [3 ]
Pinsky, Michael R. [3 ]
机构
[1] Univ Pittsburgh, Sch Nursing, 3500 Victoria St,336 Victoria Hall, Pittsburgh, PA 15261 USA
[2] Carnegie Mellon Univ, Sch Comp Sci, Robot Inst, Auton Lab, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
关键词
PHYSIOLOGICAL MONITOR ALARMS; CLINICAL ALARMS; RESPONSE-TIME; PATIENT; INTERVENTIONS; REDUCTION; SETTINGS;
D O I
10.1016/j.jelectrocard.2018.07.024
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Research demonstrates that the majority of alarms derived from continuous bedside monitoring devices are non actionable. This avalanche of unreliable alerts causes clinicians to experience sensory overload when attempting to sort real from false alarms, causing desensitization and alarm fatigue, which in turn leads to adverse events when true instability is neither recognized nor attended to despite the alarm. The scope of the problem of alarm fatigue is broad, and its contributing mechanisms are numerous. Current and future approaches to defining and reacting to actionable and non-actionable alarms are being developed and investigated, but challenges in impacting alarm modalities, sensitivity and specificity, and clinical activity in order to reduce alarm fatigue and adverse events remain. A multi-faceted approach involving clinicians, computer scientists, industry, and regulatory agencies is needed to battle alarm fatigue. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:S44 / S48
页数:5
相关论文
共 38 条
[1]  
Allan SH, 2017, JT COMM J QUAL PATIE, V43, P62, DOI 10.1016/j.jcjq.2016.11.004
[2]   Managing Alarms in Acute Care Across the Life Span: Electrocardiography one Pulse Oximetry [J].
Jepsen, Stacy ;
Sendelbach, Susan .
CRITICAL CARE NURSE, 2018, 38 (02) :E16-E20
[3]   Video Analysis of Factors Associated With Response Time to Physiologic Monitor Alarms in a Children's Hospital [J].
Bonafide, Christopher P. ;
Localio, Russell ;
Holmes, John H. ;
Nadkarni, Vinay M. ;
Stemler, Shannon ;
MacMurchy, Matthew ;
Zander, Miriam ;
Roberts, Kathryn E. ;
Lin, Richard ;
Keren, Ron .
JAMA PEDIATRICS, 2017, 171 (06) :524-531
[4]   Association between exposure to nonactionable physiologic monitor alarms and response time in a children's hospital [J].
Bonafide, Christopher P. ;
Lin, Richard ;
Zander, Miriam ;
Graham, Christian Sarkis ;
Paine, Christine W. ;
Rock, Whitney ;
Rich, Andrew ;
Roberts, Kathryn E. ;
Fortino, Margaret ;
Nadkarni, Vinay M. ;
Localio, A. Russell ;
Keren, Ron .
JOURNAL OF HOSPITAL MEDICINE, 2015, 10 (06) :345-351
[5]   Dynamic and Personalized Risk Forecast in Step-Down Units Implications for Monitoring Paradigms [J].
Chen, Lujie ;
Ogundele, Olufunmilayo ;
Clermont, Gilles ;
Hravnak, Marilyn ;
Pinsky, Michael R. ;
Dubrawski, Artur W. .
ANNALS OF THE AMERICAN THORACIC SOCIETY, 2017, 14 (03) :384-391
[6]   Using Supervised Machine Learning to Classify Real Alerts and Artifact in Online Multisignal Vital Sign Monitoring Data [J].
Chen, Lujie ;
Dubrawski, Artur ;
Wang, Donghan ;
Fiterau, Madalina ;
Guillame-Bert, Mathieu ;
Bose, Eliezer ;
Kaynar, Ata M. ;
Wallace, David J. ;
Guttendorf, Jane ;
Clermont, Gilles ;
Pinsky, Michael R. ;
Hravnak, Marilyn .
CRITICAL CARE MEDICINE, 2016, 44 (07) :E456-E463
[7]  
Chen Lujie, 2015, AMIA Annu Symp Proc, V2015, P1841
[8]   Monitor alarm fatigue: An integrative review [J].
Cvach, Maria .
Biomedical Instrumentation and Technology, 2012, 46 (04) :268-277
[9]   Use of Pagers With an Alarm Escalation System to Reduce Cardiac Monitor Alarm Signals [J].
Cvach, Maria M. ;
Frank, Robert J. ;
Doyle, Pete ;
Stevens, Zeina Khouri .
JOURNAL OF NURSING CARE QUALITY, 2014, 29 (01) :9-18
[10]  
Desai K, 2014, IEEE ENG MED BIO, P3456, DOI 10.1109/EMBC.2014.6944366